DME experience

[TimGraham1979]

With all the negativity in regards to DMEs, I'd like to share my experience.

I had my polysomnogram done at a Providence facility in Oregon. The DME I used is owned by them. I know many would feel that is a conflict; however, my experience has been mostly positive.

First step: Dr. sent referral to DME. DME got pre-authorization from insurance and called me back with an appointment for mask fitting and to pickup machine.

During appointment, staff did a mask fitting and unboxed a brand new Resmed Airsense 10 autoset. They also went over my out of pocket cost for everything. Based on my insurance plan, my out of pocket was 20%. This meant the total cost being charged to my insurance was $900.

This included heated tube, humidifier, and a mask of my choosing. Staff set settings based on prescription and explained the features and how to use the machine. I was asked if I was interested in "MyAir" and was asked for an email address for information to be sent on how to set it up. I was also told that the DME would supply 1 additional mask as a "one-time" courtesy if the original mask didn't work out. More on this later.

I was also given a schedule for the replacement supplies with a phone number and a physical location where I could pick up replacement supplies. I was advised to order everything before December 31 as that would allow me to take advantage of full insurance payment without a deductible which would start over on January 1st. I was told that I could either order over the phone and supplies would be shipped to my home, or I could go to the physical location and pick them up.

I ended up taking advantage of the "one-time courtesy mask" as the original one was not comfortable. I was given a new, complete F10 setup. There was no charge for this.

I can't comment on supply ordering, but I will update once that happens.

After reading all the horror stories about DME's I was pleasantly surprised by my experience.

[Guest]

After reading all the horror stories about DME's I was pleasantly surprised by my experience.

I look forward to hearing your thoughts in Feb/Mar 2017.
Hope the one time mask replacement works for you.

fwiw it is the mask mfg who offers this replacement and there is no charge to the DME when they submit the paperwork. Afaik there is no limit within a 30 day period so speak up if this mask doesn't work.

When you think about it - it is to the DME's benefit to make sure you are successful so they not only get the machine paid for but get a lifetime of replacement consumable supplies.

btw - it certainly is a conflict of interest. Let's face it the doc has no interest in you just his financial gain. It should be against the law as it is also unethical.

Imagine if every doc told you where to buy your meds and what brand they should be?

[LSAT]

With all the negativity in regards to DMEs, I'd like to share my experience.

I had my polysomnogram done at a Providence facility in Oregon. The DME I used is owned by them. I know many would feel that is a conflict; however, my experience has been mostly positive.

First step: Dr. sent referral to DME. DME got pre-authorization from insurance and called me back with an appointment for mask fitting and to pickup machine.

During appointment, staff did a mask fitting and unboxed a brand new Resmed Airsense 10 autoset. They also went over my out of pocket cost for everything. Based on my insurance plan, my out of pocket was 20%. This meant the total cost being charged to my insurance was $900.

This included heated tube, humidifier, and a mask of my choosing. Staff set settings based on prescription and explained the features and how to use the machine. I was asked if I was interested in "MyAir" and was asked for an email address for information to be sent on how to set it up. I was also told that the DME would supply 1 additional mask as a "one-time" courtesy if the original mask didn't work out. More on this later.

I was also given a schedule for the replacement supplies with a phone number and a physical location where I could pick up replacement supplies. I was advised to order everything before December 31 as that would allow me to take advantage of full insurance payment without a deductible which would start over on January 1st. I was told that I could either order over the phone and supplies would be shipped to my home, or I could go to the physical location and pick them up.

I ended up taking advantage of the "one-time courtesy mask" as the original one was not comfortable. I was given a new, complete F10 setup. There was no charge for this.

I can't comment on supply ordering, but I will update once that happens.

After reading all the horror stories about DME's I was pleasantly surprised by my experience.

The amount that your insurance allows will be far less than $900...(Probably about $600)Your 20% is based on the lower amount that the insurance allows.

[Omne]

The amount that your insurance allows will be far less than $900...(Probably about $600)Your 20% is based on the lower amount that the insurance allows.

What I usually run across is that the provider already knows what they're going to get and they tell me what the co-pay will be on that amount. $900 seems really low for billing on an autoset, that's lower than CPAP.com, which is around $900. I'm guessing that is the allowed price, they'll probably bill at $2K or something.

I once asked my dentist why they do that and he said if they didn't it would keep dropping.

[Janknitz]

Thanks for posting. We do rag on DME's a lot, mostly because they deserve it, but when there's a good DME they definitely deserve kudos, too.

[Bookbear]

Nice to hear of a positive DME experience. Sadly most are not so good. You were lucky!

[SewTired]

btw - it certainly is a conflict of interest. Let's face it the doc has no interest in you just his financial gain. It should be against the law as it is also unethical.

Imagine if every doc told you where to buy your meds and what brand they should be?

That's presuming the doctor is forcing the patient to only purchase from him/her. There's nothing wrong with a doc offering equipment related to their specialty. Opticians and ophthalmologists have forever, but you still have the right to your prescription so that you can go elsewhere. My own sleep doctor office have their own offerings as well, and clearly, they have a lot more interest in your success. However, I go through Medicare, so wasn't an option. It's not the doc telling you where to 'buy your meds'. It's the insurance company or the Medicare bid process (which I don't get any input into), that determines it unless you have a significant nest egg (my egg went with my medical bills long ago).